Embolization of a catheter-related hepatic artery pseudoaneurysm after long-term biliary drainage.

Hemobilia is a frequent complication of percutaneous transhepatic biliary drainage, occurring most commonly at the time of initial catheter placement. The authors report on the angiographic diagnosis and embolization of a pseudoaneurysm of the right hepatic artery in a patient with hemobilia. This occurred after 2.5 years of catheter drainage for biliary obstruction due to malignant disease. Bleeding as a complication of biliary drainage can be the result of inadvertent placement of catheter side holes in the hepatic parenchyma, iatrogenic arterioportal and arteriohepatic venous shunts and pseudoaneurysms. This case report illustrates that hemobilia, even with long-term percutaneous transhepatic biliary drainage, may be associated with a radiologically treatable, drainage-related vascular abnormality rather than simply diffuse hemorrhage from a friable tumor.